Staying Safe During Holiday Travel

If you’re one of the millions of people planning to travel over the holidays, we’d like you to do it safely. Whether your plans involve car, plane or train take a minute or two to study these simple steps to stay healthy while traveling.

“One health risk to consider when traveling is simply sitting for too long,” says Clayton Cowl, M.D., an expert in travel medicine at Mayo Clinic. “Concerns like blood clots in the legs from sitting too long, becoming dehydrated from lack of fluid intake or drinking too much alcohol, and not walking much when delayed in an airport or train station can be serious. Driving for hours to reach a destination after a long day at work can be as equally worrisome due to fatigue and eyestrain.”

Blood clots can be a concern when a person sits for too long because leg muscles aren’t contracting and blood can pool and stagnate in the vessels. This can lead to deep vein thrombosis and even pulmonary embolism – a potentially fatal condition, caused by clots becoming lodged in the lungs.  When travelling by car, both driver and passengers should stop every few hours to hydrate and walk. Plan ahead, and pick some good rest stops along your route. How about a park, a mall, or a place of interest?

As an added benefit, allowing children to run or play in a safe environment while traveling will often help curb their excessive energy in a confined space and may help them relax while traveling for longer periods.

When traveling by plane, check the in-flight magazine for tips on how to exercise in your seat and on trips longer than three hours, get up at least once to take a walk to the bathroom or other end of the plane.

And regardless of how you travel, try to avoid crossing your legs while sitting for long periods, because this can inhibit adequate blood circulation.

If you’re the one doing the driving, plan to get a good night’s sleep the day before the trip, to avoid drowsiness during the journey. If possible, take turns at the wheel with other passengers. Take breaks at rest stops and chose healthy low carb meal options, to avoid crashing after a sugar high. Combining meals or rest room stops with a short walk to get fresh air and stretch can make a big difference in staying more alert and refreshed.

While we all want to just get to our destination for the holidays, budgeting a little extra time to account for unexpected weather delays and adequate driving breaks is a really smart plan.

To avoid stiffness from sitting too long, if you’re a passenger try doing some simple stretches, such as extending legs out and back several times and massaging thighs and calves.

To avoid eyestrain and its associated annoying symptoms including sore or irritated eyes, dry or watery eyes, double vision or blurriness, increased sensitivity to light or unremitting shoulder and neck fatigue never drive if you are sleep deprived.

A short nap can significantly relieve these symptoms and non-medicated eye drops can help if eye irritation persists

Whatever your travel method, avoid dehydration. Drink plenty of water and minimize or eliminate alcohol consumption as alcohol dehydrates at a cellular level.

Above all, plan for the worst, and enjoy the best: When severe winter weather hits, many vehicles may become stranded and help may be hours or sometimes days away. Pack a simple emergency kit, including blankets, snacks, water, charging devices, flashlights and activities to keep kids amused.

Thank You for your attention. Now, please fasten your seat belts, place doors to manual and turn off all cellular devices. You’re ready for the holidays!

Bon Voyage.

Don’t end up Black & Blue this Black Friday

Congratulations!  You survived another Thanksgiving.  Hopefully the only thing that ended up being stuffed this year was your turkey.

However, the holiday hazards aren’t over yet.  Experts warn that the stress that accompanies Black Friday shopping can add costs, far greater than those we ring up at the mall.

While retail stores are raking in the money, shoppers are probably having a more negative experience. Although we all love a Black Friday deal, “it is more like Red Friday for the consumer, as the shopper goes into debt to pay for purchases,” says Nancy Barton, professor in the School of Physical Education and Tourism Management at Indiana University-Purdue University.

Besides overspending, four people have died and dozens of injuries have occurred in the Black Friday shopping frenzy in the past four years.

Who can forget the images of the trampled Walmart worker in Long Island; the collapsed man bypassed by shoppers at a West Virginia Target and a shooting at a Toys R Us over an item brawl.

Clearly, both consumers and stores are clearly unprepared for the post-Thanksgiving stress and excitement.

“Some have argued that we are wired for desire as a result of our dopamine reward pathways.” Barton adds, “When we are overstimulated by a novel experience or unlimited choices on Black Friday, a craving (for more) and insatiable desire is triggered.”

The key to combating these desires relies on the executive, thinking part of the brain. However, this control can be hindered if you are stressed out, tired and hungry, arguably the three main traits of an all-night Black Friday shopper.

How can you avoid these stressors?  How about? :

Opting out of Black Friday shopping. Think of another way to give a gift. How about buying an “experience” for your loved one(s)?  After all, there is plenty of evidence that it’s experiences, rather than things that make us happy. What about a family gym membership? Not only will you stay healthy, but the family that works out together, is more likely to stay together

Paying It Forward. Instead of spending, how about giving? Think about those who are less fortunate than you and do something for them. Visit an elderly neighbor living alone; volunteer at a local hospital / animal shelter, soup kitchen. Your smile and touch may be the greatest gift of all.

Trying some self-reflection. The perfect antidote for ungrateful feelings is to practice gratefulness.  List three things that you are grateful for. Embody the feelings of gratefulness. Positive emotions and satisfaction with what you already have will start to unfold as you reflect on your list.

Whatever you end up doing today – please stay safe.

Side Effects of Sex

It’s Monday morning, it’s cold and the holidays are still too far away to be a reality for most of us.  Not a lot to be cheerful about?  Right!

Never fear, SRxA’s Word on Health is here to help start your week off right with some health news that may just bring a smile to your face.

While many people associate a healthy lifestyle with grueling workouts, strict dieting and general deprivation and misery  – this is a misconception.

According to Dr Joseph Mercola, an osteopathic physician, web entrepreneur and New York Times best selling author, healthy habits can be among the most rewarding.  Take sex. It counts as moderately intense exercise plus it boosts numerous aspects of both physical and mental health. As long as you’re engaging in safe-sex practices, increasing your sexual activity is a surefire strategy to better health!

Mercola suggests regular sex can reduce stress, bolster self-esteem and foster feelings of intimacy and bonding between partners.  Better still, a healthy sex life can result in a longer, healthier and, most would agree, more enjoyable life.

In case that’s not enough – here’s 10 more healthy side effects of sex:

1. Improved Immunity

People who have sex frequently have significantly higher levels of immunoglobulin A (IgA). IgA is part of the immune system that forms your body’s first line of defense. Its job is to fight off invading organisms at their entry points, reducing or even eliminating the need for activation of your body’s immune system. This may explain why people who have sex frequently also take fewer sick days.

2. Heart Health

According to one study, men who made love regularly (at least twice a week) are 45% less likely to develop heart disease than those who did so once a month or less.

Sexual activity not only provides many of the same benefits to your heart as exercise but also keeps levels of estrogen and testosterone in balance, which is important for heart health.

3. Lower Blood Pressure

Sexual activity, and specifically intercourse, is linked to better stress response and lower blood pressure.

4. It’s a Form of Exercise

Sex helps to boost your heart rate, burn calories and strengthen muscles, just like exercise. In fact, research recently revealed that sex burns about 4 calories a minute for men and 3 for women, making it (at times) a ‘significant’ form of exercise. It can even help you to maintain your flexibility and balance.

5. Pain Relief

Sexual activity releases pain-reducing hormones and has been found to help reduce or block back and leg pain, as well as pain from menstrual cramps, arthritis and headaches. One study even found that sexual activity can lead to partial or complete relief of headache in some migraine and cluster-headache patients.

6. Help to Reduce Risk of Prostate Cancer

Research has shown that men who ejaculate at least 21 times a month (during sex or masturbation) have a lower risk of prostate cancer.

7. Improve Sleep

After sex, the relaxation-inducing hormone prolactin is released, which may help you to nod off more quickly. The “love hormone” oxytocin, released during orgasm, also promotes sleep.

8. Stress Relief

Sex triggers your body to release it’s natural feel-good chemicals, helping to ease stress and boost pleasure, calm and self-esteem. Research also shows that those who have sexual intercourse responded better when subjected to stressful situations like speaking in public.

9. Boost Your Libido

The more often you have sex, the more likely you are to want to keep doing it. There’s a mental connection there but also a physical one, particularly for women. More frequent sex helps to increase vaginal lubrication, blood flow and elasticity, which in turn make sexual activity more enjoyable.

10. Improved Bladder Control in Women

Intercourse helps to strengthen pelvic floor muscles, which contract during orgasm. This can help women improve their bladder control and avoid incontinence.

Happy Monday!

Immune to Stress?

Following on from last Friday’s post on the beneficial effects of stress hormones, we bring you news of study that helps us to better understand the stress process at a cellular level and how stress can lead to mood disorders.

The new research from Ohio State University, published in The Journal of Neuroscience, shows that certain cells from the immune system are recruited to the brain during stress, causing symptoms of anxiety.

Researchers discovered the dynamic mind-body interaction – a two-way communication from the central nervous system to the rest of the body – and back to the central nervous system that ultimately influences behavior during prolonged stress.

Under prolonged stress, the brain sends signals out to the bone marrow, calling up monocytes. The cells travel to specific regions of the brain and generate inflammation that causes anxiety-like behavior.

In experiments conducted in mice, researchers showed that repeated stress exposure caused the highest concentration of monocytes migrating to the brain. The cells surrounded blood vessels and penetrated brain tissue in several areas linked to fear and anxiety, including the prefrontal cortex, amygdala and hippocampus, and their presence led to anxiety-like behavior in the mice.

“In the absence of tissue damage, we have cells migrating to the brain in response to the region of the brain that is activated by the stressor,” said John Sheridan, senior author of the study. “In this case, the cells are recruited to the brain by signals generated by the animal’s interpretation of social defeat as stressful.”

The mice in this study were subjected to stress that might resemble a person’s response to persistent life stressors. In this model male mice were given time to establish a hierarchy, and then an aggressive male was added to the group for two hours. This elicits a “fight or flight” response in the resident mice as they are repeatedly defeated. The experience of social defeat leads to submissive behaviors and the development of anxiety-like behavior.

Mice subjected to zero, one, three or six cycles of this social defeat were then tested for anxiety symptoms. The more cycles of social defeat, the higher the anxiety symptoms. For example, the mice took longer to enter an open space and opted for darkness rather than light when given the choice. Anxiety symptoms corresponded to higher levels of monocytes that had traveled to the animals’ brains from the blood. Additional experiments showed that these cells did not originate in the brain, but traveled there from the bone marrow.

Exactly what happens at this point in the brain remains unknown, but the research offers clues. The monocytes that travel to the brain don’t respond to natural anti-inflammatory steroids in the body and have characteristics signifying they are in a more inflammatory state.

These results indicate that inflammatory gene expression occurs in the brain in response to the stressor.

These findings do not apply to all forms of anxiety, the scientists noted, but they are a game-changer in research on stress-related mood disorders.

“Our data alter the idea of the neurobiology of mood disorders,” said Eric Wohleb, a pre-doctoral fellow in Ohio State’s Neuroscience Graduate Studies Program. “We’re saying something outside the central nervous system – something from the immune system – is having a profound effect on behavior.”

Adrenaline Junkie

Although we repeatedly hear about the negative health effects of stress, today we’re here to tell you that stress isn’t necessarily all bad. Like food, sex, and shoes, it’s quality, not quantity, that determines whether stress helps or hurts!

Beneficial stress comes in the form of an acute, stimulating surge, like when your raft starts to overturn in some seriously churning rapids. The resulting single adrenaline (epinephrine) burst that comes and goes very quickly is a good thing because it gives you energy and gets you ready to mobilize for immediate action.

Physiologically, the adrenaline created by an abrupt blast of stress sends a flood of oxygen-rich red blood cells through your body, boosts your immune system, and signals your brain to start releasing painkilling endorphins.

Bad stress, on the other hand, is intense and drags on and on. This constant grind causes your adrenal glands to leak a slow, steady stream of another stress hormone: cortisol. And unlike adrenaline, which tends to hit your system in a flash and then dissipate, cortisol often wears out its welcome by hanging around in your bloodstream, driving up blood pressure, suppressing your immune system, and making you more susceptible to a slew of stress-related ailments, including colds, irritable bowel syndrome, migraines, and even heart disease and stroke.

So how do good stressors battle the bad ones? It all comes back to the positive power of adrenaline. In addition to all of its performance-enhancing effects, it triggers the release of dopamine and endorphins, two neurotransmitters that make you feel good – really, really good.

It also makes me feel good – really, really good, given the activities I have planned this weekend. But more of that later…

For now, let’s return to our favorite stress hormone – epinephrine. If you’ve ever tried skydiving, bungee jumping or heli-skiing, you’ll probably remember literally flipping out during your first attempt. But once you landed safely you probably experienced a euphoric, fist-pumping high thanks to dopamine flooding your brain’s pleasure center, giving you. During the next jump, you may still have felt all the same physiological stress responses such as a pounding heart and sweaty palms but instead of being terrifying, it’s exhilarating, because your mind’s already anticipating the thrill of that dopamine reward.

And the more times you do it, the less anxiety you’re likely to feel and the more fun you’ll have. That’s because your brain’s tagging the experience as a positive one.

And the benefits persist.  Before long, your body can start to develop an almost Pavlovian response to stressful situations. If your nerves are tingling, your stomach is clenching, and you can barely breathe, then it’s tricked into thinking something really awesome is about to happen!

That’s what researchers at Texas A&M University found when they put a small sample of men and women through a series of purposely stressful outdoor adventure tasks. Some subjects – the fittest ones who were already comfortable with physical challenges fared better than others. The researchers discovered that those participants had a reduced stress response (including lower blood levels of cortisol) when facing demanding activities like whitewater canoeing or rock climbing. Essentially, they were more confident and less stressed out, even though the tasks were potentially hazardous. This may be because their past experience blazing through strenuous situations made them less likely to perceive new challenges as stressful or difficult. And according to the researchers, it’s possible to transfer that oh-so-cool-and-collected response to life’s other nerve-racking events.

Better still, you don’t have to scuba dive with great whites or BASE jump off the Empire State Building to reap the stress-busting perks of adrenaline. Whether you hit the bunny slope or the double-black-diamond mogul fields, as long as you’re taking a giant step outside your comfort zone, you’ll give your body that adrenaline kick and when you do it regularly and keep testing your edge, you’ll change your relationship with stress for the better.

So next time that little voice inside your head starts clamoring, no freaking way, just go for it and be prepared to reap the rewards.

Which brings me back to my weekend. Keen to test the above theory for myself and readers of SRxA’s Word on Health, I will be spending tomorrow riding some of the longest, highest, fastest most insane rollercoasters in the country…and the following day I will be running with the bulls. If being pursued by twenty-four 1,000-pound bulls doesn’t set my adrenaline firing on all cylinders, then I guess nothing will.

I”ll let you know (hopefully) on Monday!

Should You Stay or Should You Go?

Picture this familiar scene. A critically injured person is wheeled into the emergency room by paramedics. Concerned, shocked and occasionally hysterical family members rush to the patient’s side. An army of doctors, nurses and techs begin emergency resuscitation efforts, inserting breathing tubes, CPR, starting IV’s, drawing blood, administering drugs and other fluids.  One of these health care professionals, nodding toward the family and screaming “Get them out of here!”

We’ve all see it… either in real life or on TV.

Cutting to the next scene, the family is escorted into a stark family crisis room. While healthcare staff work desperately to resuscitate the patient, a social worker updates the family on their progress. If the patient dies, staff  make him as presentable as possible, and then invite the family in to say good-byes. The social worker supports the family during this difficult time, and the code team return to their care of other patients.

For decades, this approach seemed to work well. The common wisdom was that if we did let the family in during the code, they’d either get in the way or become so distraught that we’d have more patients on our hands. Furthermore, we felt we were doing the family a greater service by letting them see their loved one only after we’d removed tubes and lines, even though the calm scene we produced was in total contradiction to actual events.

But recently, this traditional approach has been questioned. It turns out that many family members want to be present during resuscitation efforts, rather than hidden away in a side room.

And even though health care professionals are still divided on whether families should be present, most agree the issue must be addressed.

Now, research is starting to question whether family members be allowed to remain in the room as these potentially lifesaving efforts begin?

A two-year study led by a researcher Jane Leske PhD, has shown that family members – parents, spouses, fiancées and adult children – of trauma patients, can benefit by being present during critical moments of care.

“Those who do choose to do it really want to be there,” says Leske, professor of nursing at the University of Wisconsin-Milwaukee. “They want to watch everything and get information. It lowers their anxiety and stress to see that everything possible is being done. Seeing is believing.”

However, family presence during resuscitation is controversial and underutilized. Indeed, many health care professionals and hospitals argue against it, concerned that the procedures may be too traumatic for family witnesses, or that family members may become emotionally out of control and interfere with care.

Leske conducted this study in collaboration with medical staff at a facility where families have the option of staying and observing resuscitation efforts. It compared outcomes for family members of patients, ages 18-93, with critical injuries from gunshot wounds or motor vehicle accidents at a Southeast Wisconsin Level 1 trauma center.  The center had offered family presence during resuscitation for more than two years by the time Leske’s study began.

The study focused on 140 family members over age 18, divided in two roughly equal groups – those who opted to remain with the victim during resuscitation; and those who chose not to, or were not able to reach the emergency department in time. Researchers interviewed family members within 72 hours after admission to the surgical intensive care unit, to discuss the family’s coping resources, communication and anxiety levels.

She and her research team found a number of benefits to having family members present, and no drawbacks.

They concluded that while families can benefit from being present during resuscitation, it’s also important that the hospital have policies and procedures in place on when and how to allow the option. For example, family presence during resuscitation should not be permitted when family members are intoxicated, extremely agitated or emotionally unstable.

Other researchers agree. A large French study published last month in the New England Journal of Medicine concluded that relatives who did not witness CPR had post-traumatic stress disorder (PTSD)–related symptoms of anxiety and depression more frequently than those who did witness CPR. Family-witnessed CPR did not affect resuscitation characteristics, patient survival, or the level of emotional stress in the medical team and did not result in medico-legal claims.

What are your thoughts on this?  Would you want to stay…or walk away.  Let us know.

Does Belly Fat cause tumors to go Belly Up?

People store fat in two ways – one you can see and one you can’t. The fat you can see is just under the skin in the thighs, hips, buttocks, and abdomen. That’s called subcutaneous fat. The fat you can’t see is deeper inside, around the vital organs – heart, lungs, digestive tract, liver as well as in the chest, abdomen, and pelvis. That’s called visceral fat.

Many people are self-conscious about the fat they can see. But actually, it’s the hidden visceral fat that may be a bigger problem, even for thin people.  Having too much of it is linked to a greater chance of developing high blood pressure, type 2 diabetes, heart disease, dementia, and certain cancers.

According to a new study published in the journal Cancer Prevention Research, visceral fat is directly linked to an increased risk for colon cancer.

“There has been some skepticism as to whether obesity per se is a bona fide cancer risk factor, rather than the habits that fuel it, including a poor diet and a sedentary lifestyle,” said Derek M. Huffman, Ph.D., postdoctoral fellow at the Institute for Aging Research at the Albert Einstein College of Medicine in Bronx, N.Y. “Although those other lifestyle choices play a role, this study unequivocally demonstrates that visceral adiposity is causally linked to intestinal cancer.

Prior research has shown that obesity markedly increases the likelihood of being diagnosed with, and dying from, many cancers. In this animal study, Huffman and his colleagues wanted to see if removing visceral fat in mice genetically prone to developing colon cancer might prevent or lessen the development of these tumors.

To do this they randomly assigned the mice to one of three groups. Mice in the first group underwent a sham surgery and were allowed to eat an unrestricted “buffet style” diet, which resulted in them becoming obese. Those in the second group were also provided an unrestricted diet and became obese, but they had their visceral fat surgically removed at the outset of the study. Mice in the third group underwent a sham surgery, but were then put on a calorie restricted diet causing them to lose visceral fat.

“Our sham-operated obese mice had the most visceral fat, developed the greatest number of intestinal tumors, and had the worst overall survival,” Huffman said. “However, mice that had less visceral fat, either by surgical removal or a calorie-restricted diet, had a reduction in the number of intestinal tumors. This was particularly remarkable in the case of our group where visceral fat was surgically removed, because these mice were still obese, they just had very little abdominal fat.”

The researchers then subdivided the groups by gender. In female mice, the removal of visceral fat was significantly related to a reduction in intestinal tumors, but calorie restriction was not. In male mice, calorie restriction had a significant effect on intestinal tumors, but removal of visceral fat did not.

These finding suggest what most women have known for years i.e., that there are important gender differences when it comes to weight. But it also provided an explanation for how belly fat, diet and cancer risk are linked.  In addition, the study emphasizes the need to promote strategies that reduce abdominal fat in obese individuals.

So how can you get rid of this dangerous deep belly fat?  According to experts, there are four: exercise, diet, sleep, and stress management.

Exercise: Vigorous exercise trims fat, including visceral fat. It can also slow down the build-up of visceral fat that tends to happen over the years. But forget spot-reducing. There aren’t any moves you can do that specifically target visceral fat. Half an hour of vigorous aerobic exercise, done four times a week is ideal.  Jog, if you’re already fit, or walk briskly at an incline on a treadmill if you’re not yet ready for jogging. Vigorous workouts on stationary bikes and elliptical or rowing machines are also effective.

Diet: There is no magic diet for belly fat. But when you lose weight on any diet, belly fat usually goes first.  A fiber-rich diet may help. Research shows that people who eat 10 grams of soluble fiber per day, without any other diet changes, build up less visceral fat over time than others. That’s as easy as eating two small apples or a cup of green peas.

Sleep: Getting the right amount of shut eye helps. In one study, people who got six to seven hours of sleep per night gained less visceral fat over 5 years compared to those who slept five or fewer hours per night or eight or more hours per night.

Stress: It’s unavoidable, but what you do with your stress matters. When you’re stressed you  tend not to make the best food choices when they’re stressed. Getting social support from friends and family, meditating, and exercising can all help to tame stress.

Short on time? If you could only afford the time to do one of these things, exercise probably has the most immediate benefits, because it tackles both obesity and stress.

Help for the Holiday Blues

It’s the most wonderful time of the year
With the kids jingle belling
And everyone telling you “Be of good cheer”
It’s the most wonderful time of the year
It’s the hap-happiest season of all
With those holiday greetings and gay happy meetings
When friends come to call
It’s the hap- happiest season of all

For many this truly is the happiest and most wonderful time of the year. But for those who have lost a loved one, the empty chair at the table or fewer presents under the tree can be a painful reminder of our loved ones who are no longer with us.

“There are so many traditions associated with the holiday season that it can be an emotional roller coaster for someone who has recently lost a loved one,” says Nancy Kiel, bereavement coordinator for Loyola University Health System. “Many people wish they could just fast forward through the holidays, but getting through the season is possible if you give yourself permission to be flexible.”

So for all those who are grieving and mourning the loss of someone this Holiday season here’s some tips that might help make the holidays a little brighter.

1. Discuss holiday plans as a family. Everyone is feeling the loss, so talk about what you are going to do and be willing to compromise. If you don’t like the change you made, next year you can always go back to the way you did it before.
2. Skip the mall. Christmas shopping can be stressful even when not dealing with grief. Consider giving gift cards or shop online to avoid the mall madness. Remember it’s not just about the presents, but about the presence of caring and supportive people.
3. You can say no. The party invitations and social gatherings might be more difficult this year. You can say no or give yourself some breathing room by asking to RSVP at a later date. If you do go, drive yourself. This will allow you the freedom to leave at your discretion. Also, try to avoid “should people” who say “you should do this or you should do that.”
4. Honor your loved one. Start a new tradition to honor and remember your loved one. You could light a special candle, at dinner have everyone at the table share a favorite memory or all take part in a loved one’s favorite holiday activity. Do something that would make your loved one smile.
5. Be gentle with yourself. Do what you need to do and pamper yourself. If you need to take a nap, take a nap. Exercise is a great stress reliever, so bundle up and take a walk.
6. It’s OK to change traditions. Do something different this year. Take a vacation somewhere hot. Skip the cooking and go to a restaurant, volunteer with those even less fortunate.

“Grief is hard work and it can be exhausting, but it is something we must do,”  advises Kiel. “If you put it on a back burner you’ll never heal. You can’t go around, over or under grief – you have to go through it. So find someone who will listen unconditionally and tell your story.”

For more information, visit www.loyolamedicine.org or call Nancy Kiel at (708) 216-1646.

Is Your Doctor Burned Out?

Is life / work stressing you out?  Thinking about going to see your doctor for help?  Before making that appointment you may want to think again.

According to a national survey of physicians, released this week nearly 1 in 2 US doctors are themselves suffering from burnout.  That’s more than any other US workers.

Overtaxed doctors are not only at risk for personal problems, like relationship issues and alcohol misuse, but their job-related fatigue can also erode professionalism, compromise quality of care, increase medical errors and encourage early retirement – a potentially critical problem as an aging population demands more medical care.

Survey participants completed a 22-item Burnout Inventory questionnaire, which measured emotional exhaustion, depersonalization (treating patients as objects rather than human beings) and low sense of personal accomplishment. Of the 27,276 physicians asked to participate, 26.7% responded. They had to report only one symptom to be included among those reporting burnout.

Differences in burnout rate varied by specialty: While most people assume that the surgical or cancer specialties would be at highest risk, the researchers from the Mayo Clinic found that emergency medicine, internal medicine, neurology and family medicine reported the highest rates.

“Nearly 60% of physicians in those specialties had high levels of burnout,” says says lead author Tait Shanafelt MD. “This is concerning since many elements critical to the success of health care reform are built upon increasing the role of the primary care providers.”

On the other hand, doctors practicing pathology, dermatology, general pediatrics and preventive medicine had the lowest rates of burnout.

In other words, it’s the physicians on the front line of care who are most likely to burn out.

And that’s not all. When asked about emotional exhaustion, 37.9% of physicians reported signs, compared with 27.8% reported by other workers surveyed.

“The rates are higher than expected,”. Commented Shanafelt “We expected maybe 1 out of 3.

Being asked to see more patients and not having enough time to spend with them creates an atmosphere of being on a hamster wheel, says physician Jeff Cain, president-elect of the American Academy of Family Physicians.

While the current prevalence of burnout is alarming many predict it could get worse as health care reform takes hold and the medical profession has to take on the additional workload associated with the millions of patients who will be newly insured under the health care law.

While the Affordable Care Act will put more pressure on the front lines, this new study could be an important wake-up call. The country needs to hear to build multidisciplinary health care teams to meet the need and help unburden our poor put-upon physicians, so they in turn can help us.

Are Isolation and Ice-Cream Bad for Your Breasts?

Do you often curl up alone in your room with a bag of potato chips or a gallon of ice cream?  After reading this, you may want to think again. According to researchers at Georgetown’s Lombardi Comprehensive Cancer Center, stress from social isolation and a high-fat diet increase levels of a brain neurotransmitter that promotes obesity, insulin resistance and breast cancer risk. The findings of the study, were reported at the 2011 American Association for Cancer Research(AACR) Annual Meeting. The study compared 4 groups of mice:

• a group that lived together (not socially isolated) and ate a normal diet;
• a group that was isolated (each alone in a cage) and ate normally;
• an isolated group that ate a high-fat diet;
• a group that lived together and ate a high-fat diet.

Results showed that the mice that were isolated and given a high-fat diet developed a major increase in the level of the neurotransmitter NPY.  At the end of 17 weeks 92% of the mice in this group had developed cancers. Mice that were isolated for two weeks but fed a control diet also had elevated neurotransmitter levels but, the tumors that developed in the high-fat, socially isolated mice appeared earlier and were larger than in the other groups. The researchers say their findings appear to link to a number of findings in humans, such as the fact that social isolation is associated with an increased risk of cancer development and mortality, and that obesity is a risk factor for breast cancer. Although they suspect that NPY may play a role in development of human breast cancer, there is currently no evidence for such a connection because human studies have not yet been done. “We have yet to translate these findings to humans, but it does suggest that social isolation is a potent stressor and initiates a robust central nervous system response,” says Allison Sumis, a Ph.D. student in GUMC’s tumor biology program.

I don’t know about you, but I’m going out to meet friends for a salad tonight!